First month after infection is key time to tackle drug-related HIV spread

November 8, 2016, University of Oxford
HIV infecting a human cell. Credit: NIH

Data from the mid-1990s AIDS epidemic in Russia and Ukraine shows that the first month after infection is the key period to control the spread of the virus in drug-using populations, according to a new study by researchers at Oxford University. Crucially, needle exchange programmes and other 'harm reduction' approaches are the only measures that can target transmissions that happen within the first month.

HIV epidemics in people who inject drugs have been on the rise in recent years, including cases in Indiana, USA and Glasgow, UK, raising the question of which measures should be prioritised by authorities - particularly in regions with limited resources, such as the recently affected areas of the Middle East, northern Africa and southeastern Asia.

The research is published in the journal AIDS.

Lead author Tetyana Vasylyeva, a doctoral candidate in the Department of Zoology at Oxford University, said: "The HIV epidemic among in Russia and Ukraine following the collapse of the Soviet Union is the biggest of its kind ever recorded. From around only 50 cases per year by 1993, the epidemic grew to several thousand cases in 1994. By the end of the decade, over 1 million people were infected across the two countries—the majority of them drug users.

"There was very little in the way of a preventive effort in this epidemic, which makes it a good model to study."

The researchers analysed all publicly available HIV genetic sequences sampled in Russia and Ukraine from 1993 to 2013 and combined this information with UN prevalence estimates relating to the epidemic. They fed this data into complex mathematical models to allow them to reconstruct the history of the virus and predict, based on the transmission timeline, which interventions would be most effective among drug users. During their analysis, the researchers found that each HIV-infected drug user infected another ten people with the virus, with the infection generally being passed on within the first month of it being contracted.

Tetyana Vasylyeva added: "Without the right interventions, the spread of HIV among drug-using populations is a public health timebomb.

"While it's still very important to get recently infected people into treatment, we have shown that harm reduction measures are crucial to controlling the spread of the virus. Treatment on its own is not effective enough."

Senior author Dr Gkikas Magiorkinis, also of Oxford's Department of Zoology, said: "Drug users are a very difficult group in which to study the transmission of infections such as HIV. We have shown that there is a crucial window of intervention when a potential can be controlled.

"The key finding of this study is that identifying recently infected people is the most important intervention we can make.

"There is also an important policy message here around the support of needle exchange programmes."

Explore further: Official: Fourth-largest city in Russia has HIV epidemic

More information: The paper 'Mitigating HIV in people who inject drugs is impossible without targeting recently-infected: what we learned from Russia and Ukraine' is published in the journal AIDS on Wednesday 9 November 2016.

Related Stories

Official: Fourth-largest city in Russia has HIV epidemic

November 2, 2016
Russian health officials say one in 50 people in the country's fourth-largest city is carrying the HIV virus as Russia struggles to deal with a rapidly rising number of infections.

Quest to end AIDS epidemic at risk: UN

July 12, 2016
Efforts to end the global AIDS pandemic by 2030 are lagging, the UN warned Tuesday, decrying rising numbers of new HIV infections among adults in many regions, with Russia especially hard-hit.

Russia warns of two million HIV carriers in five years

May 14, 2015
Russia's AIDS epidemic is worsening and at least two million people are likely to be infected with HIV in about five years as the virus increasingly affects the heterosexual population, the country's top AIDS specialist said ...

AIDS: Crimean drug users at risk, says NGO

March 20, 2014
More than 14,000 injecting drug users in Crimea risk being cut off from life-saving treatment and services prohibited in Russia, an NGO working to halt HIV spread warned on Thursday.

UN plan to end AIDS by 2030 faces Russian resistance

June 8, 2016
UN member-states agreed on Wednesday to fast-track their response to end the AIDS pandemic by 2030 despite a last-minute bid by Russia to dilute efforts to focus on drug users and gay men.

Recommended for you

Researchers find new way to defeat HIV latency

March 8, 2018
HIV, the virus that causes AIDS, has a secret life. Though anti-retroviral therapy can reduce its numbers, the virus can hide and avoid both treatments and the body's immune response.

Broadly neutralizing antibody treatment may target viral reservoir in monkeys

March 5, 2018
After receiving a course of antiretroviral therapy for their HIV-like infection, approximately half of a group of monkeys infused with a broadly neutralizing antibody to HIV combined with an immune stimulatory compound suppressed ...

HIV begins to yield secrets of how it hides in cells

March 2, 2018
UC San Francisco scientists have uncovered new mechanisms by which HIV hides in infected cells, resting in a latent state that evades the body's immune system and prevents antiviral drugs from flushing it out.

HIV exports viral protein in cellular packages

February 15, 2018
HIV may be able to affect cells it can't directly infect by packaging a key protein within the host's cellular mail and sending it out into the body, according to a new study out of a University of North Carolina Lineberger ...

Can gene therapy be harnessed to fight the AIDS virus?

February 13, 2018
For more than a decade, the strongest AIDS drugs could not fully control Matt Chappell's HIV infection. Now his body controls it by itself, and researchers are trying to perfect the gene editing that made this possible.

Big data methods applied to the fitness landscape of the HIV envelope protein

February 7, 2018
Despite significant advances in medicine, there is still no effective vaccine for the human immunodeficiency virus (HIV), although recent hope has emerged through the discovery of antibodies capable of neutralizing diverse ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.